In this application we propose to establish a Center of Excellence to be called the Columbia Center for the Health of Urban Minorities (CHUM). This proposal originates in a longstanding relationship between Columbia University's Health Sciences Division and two Northern Manhattan minority communities one predominantly Latino and the other mostly African-American. Both, Columbia's medical school and school of public health are Hispanic Serving Health Professions Schools. Also, one of the principal affiliates in this application, Harlem Hospital has long been a predominantly minority serving health institution. The University has selected two of its minority investigators to lead CHUM. A highly productive investigator who in a short time has become a leading national figure in the field of minority health and health disparities will serve as principal investigator while one of the University's most senior investigators will serve as co-principal investigator and scientific director. Both investigators are also involved in training and have numerous contacts with community organizations. Furthermore, of the 18 directors or co-directors in each of the nine proposed cores, nine are either Latino or African-American. Building on existing research programs we propose to develop an interdisciplinary center of research in minority health and health disparities Although disparities are multi-factorial in etiology there is little evidence of biological underpinnings of racial/ethnic health disparities and extensive evidence of disparities in receipt of quality health care. Accordingly, the research focus of CHUM will be access to care. One research core will focus on primary (financial) barriers to care and other cores will focus on non-financial barriers in four specific areas: cardiovascular disease, mental health, diabetes and injury and disability prevention. Using Columbia University's established ties to the community we propose to develop a new paradigm in community participatory research by the creation of a community planning council and a public health promotion specialist to serve as a liaison between the academic health center and the community. CHUM will also support the training and research career development of minority investigators and provide the university with a unique opportunity to develop and institutionalize a cross-cultural curriculum for medical students. [unreadable] [unreadable]